Experienced Customer Service Representative – Remote Opportunity with blithequark's MI-based Health Plan

At blithequark, we're committed to delivering exceptional patient care and innovative healthcare solutions to our communities. As a leading health network with a presence in Michigan and Indiana, we're dedicated to fostering a culture of high performance and collaboration. We're now seeking an experienced Customer Service Representative to join our team and help drive our organization forward.

About blithequark

blithequark is a fully integrated health network that's passionate about providing quality, evidence-based patient care. With a network of 13 hospitals in Michigan, ambulatory surgery centers, imaging centers, a primary and specialty care physician network, commercial and Medicaid HMOs, home health, infusion, and hospice providers, pharmacy services, a clinical laboratory network, and a wholly owned medical malpractice insurance company, we're committed to meeting the diverse healthcare needs of our communities. Our organization is anchored by the Karmanos Cancer Institute, one of only 53 National Cancer Institute-designated comprehensive cancer centers in the U.S.

Join Our Dynamic Team

As a Customer Service Representative with blithequark's MI-based health plan, you'll be part of a dynamic organization that values the talents and abilities of all our employees. We're committed to fostering an open, cooperative, and dynamic environment where employees and the health plans can thrive. As an employee of blithequark, you'll be a leader in driving our organization forward and delivering quality service to all our members.

Key Responsibilities

As a Customer Service Representative, you'll be responsible for:

• Handling daily member telephone calls, including directing members to the proper services needed, educating members, problem-solving, and creating linkages to the Medical Management Department for authorization of services
• Assisting providers with eligibility, benefit, and resolution of claims issues
• Providing exceptional customer service to our members, addressing their concerns, and resolving their issues in a timely and professional manner
• Collaborating with our Medical Management Department to ensure seamless communication and efficient service delivery
• Maintaining accurate records and documentation of member interactions and service requests
• Staying up-to-date with changes in our health plan's policies, procedures, and benefits to provide accurate information to our members

Essential Qualifications

To be successful in this role, you'll need:

• A High School Diploma or equivalent certification
• One (1) year of experience in a customer service-related role with direct contact with customers via telephone, email, chat, and/or face-to-face
• Excellent communication and interpersonal skills, with the ability to build rapport with members and providers
• Strong problem-solving and analytical skills, with the ability to resolve complex issues in a timely and professional manner
• Ability to work in a fast-paced environment, with multiple priorities and deadlines
• Proficiency in Microsoft Office and other software applications

Preferred Qualifications

While not required, we're looking for candidates with:

• One (1) year of experience in a physician healthcare office environment or high-volume call center
• One (1) year of experience and knowledge of HMO, PPO, TPA, PHO, and Managed Care functions
• Experience with healthcare software applications, such as electronic health records (EHRs) and practice management systems (PMS)

What We Offer

As a valued member of our team, you'll enjoy:

• A competitive salary and benefits package, including medical, dental, and vision insurance, 401(k) matching, and paid time off
• Opportunities for career growth and professional development, with training and education programs to help you advance in your career
• A dynamic and supportive work environment, with a team of dedicated professionals who are passionate about delivering exceptional patient care
• Flexible scheduling, with the option to work remotely and maintain a healthy work-life balance
• Recognition and rewards for outstanding performance and contributions to our organization

Equal Opportunity Employer

blithequark is an Equal Opportunity Employer, committed to diversity, equity, and inclusion. We welcome applications from qualified candidates of all backgrounds, and we're dedicated to creating a workplace that's inclusive and respectful of all employees.

How to Apply

If you're a motivated and customer-focused individual who's passionate about delivering exceptional patient care, we encourage you to apply for this exciting opportunity. Please submit your application, including your resume and a cover letter, through our online application portal. We can't wait to hear from you! Apply Now! Apply for this job